by Scott Blum
He then reached into his faded jeans and pulled out a large black-handled pocketknife. With a flick of his wrist, the blade scissored open and gleamed in the sunlight that shone through the bus window. The weapon had serrated teeth halfway down the blade that looked like they could easily saw through bone.
“Maybe I should gut you like a buck.” He laughed as he mimed the shape of a cross with his knife. “Put you out of your misery.”
I looked up at the bus driver and noticed that his eyes were on the road for once. He was always looking in the large mirror above his head to keep the “precious cargo” in check, but for some reason on this day he decided to watch where he was going on the desolate twolane highway.
“Don’t say a word.” Jim had stopped laughing. “Or I will gut you.”
He pushed me forward and slammed my forehead into the back of the galvanized-metal seat in front of us. I felt the shell necklace dig into the soft flesh of my throat. As he sliced the fishing line that held it together, dozens of tiny pukas scattered on the floor, rolling down the aisle.
“Now look what you’ve done.” He laughed. “You gotta be more careful with your momma’s jewelry!”
Within seconds the bus filled with crunching noises as dozens of enthusiastic feet began stomping on the shells. My favorite necklace was reduced to thousands of tiny shards in a matter of seconds.
“No joke,” Jim calmly whispered as he again flashed the angry weapon and returned it to his pocket. “Like a buck.”
As the bus rolled into the school parking lot, I squeezed my eyes shut tightly so my tears would remain locked inside. Thanks to my “fashion consultant” and his razor-edged assistant, I learned a valuable lesson that day:
Boys don’t cry.
After waking up, I wasn’t able to get back to sleep. I knew that girls had different challenges than boys, but I began to doubt if I was truly ready to be responsible for a child’s emotional safety.
If I was still upset by what had happened during my own childhood, how could I be a parent to somebody else?
CHAPTER SIX
The next few weeks were filled with repeated visits to the doctor that gave me a crash course in the medical aspects of pregnancy. By the time we were nine weeks along, Madisyn had already endured multiple ultrasounds and several appointments with a team of professional “blood-suckers.” At first the ultrasound was interesting, but after repeated viewings of the blurry peanut on the screen, the invasive procedure began to lose its charm.
“I don’t know about Dr. Carducci,” I said to Madisyn as we were driving away from the doctor’s office after another round of blood tests had been scheduled.
“Why not? I think she’s nice.”
“Yes, she’s nice, but she hasn’t exactly honored your request that this be a natural experience.”
“She’s just being extra careful because of my age.”
“I think she’s relying on traditional medical procedures to protect herself from being sued. Maybe we should ask around to see if we can find a good midwife. Do you really want to have the baby in a cold hospital anyway?”
“I didn’t, but I’m starting to feel that the doc has a valid point about having the extra support in case something goes wrong. And besides, they do have a water-birth center at the hospital, and she says we can play any music we want during labor.”
I was surprised that my wife was defending Dr. Carducci, given how opposed to traditional medicine she had been the entire time I’d known her. But I understood that this was a scary time for her, and ultimately she was the one who needed to feel most comfortable with whatever path we were taking.
“And besides,” Madisyn continued, “I’m still worried that the spotting might turn into something bad.”
“Even the doc said that’s probably nothing to worry about.” I tried to reassure her.
“I know, but she also said it’s possible—”
“Okay,” I interrupted as gently as I could. “If you feel comfortable with the doctor, then we’ll stay with her.”
“I think it’s a good idea,” my wife said as we pulled up to our shared office. “Let’s get back to work so I can try to get ahead before Autumn arrives.”
The next morning Madisyn woke up utterly exhausted and wasn’t able to get out of bed the entire day. Fortunately, it was Saturday, so I was able to stay at home and take care of her without having any other obligations to attend to.
At first we thought it was simply a normal case of morning sickness, but as the day progressed, her spotting had turned bright red and her abdominal pain had come to be nearly unbearable. I was finally able to convince my wife to let me call the doctor around 9:00 P.M., although we knew it was unlikely she’d be able to see Madisyn on the weekend. We had to jump through hoops to persuade the answering service to page the doctor on a Saturday night, and she finally returned our call after several minutes that seemed like hours.
“Hello, it’s Dr. Carducci.”
“It’s Madisyn’s husband, Scott. Madisyn isn’t doing too well—could you come and see her?”
“What’s wrong?”
“She’s in terrible pain. Her abdomen is killing her … and she’s starting to bleed a lot!”
“She should go to the emergency room,” the doctor said firmly.
“That’s what I suggested earlier, but she doesn’t want to go to the hospital. Is there anything you can call in for the pain until we can see you?”
“They can give her what she needs at the emergency room.” Dr. Carducci was getting impatient. “I’ll call the hospital to let them know to expect you. Go now. Do you need me to call an ambulance?” When she mentioned an ambulance, it finally sunk in how serious it was. Even though I’d been trying to convince Madisyn to go to the hospital for hours, hearing the doctor’s adamant directive made me feel that I should have insisted earlier.
“She said that we need to go to the emergency room immediately,” I told Madisyn, after hanging up the phone.
She resisted at first, but when I explained that the only other option was to call an ambulance, she begrudgingly agreed to let me guide her to the passenger seat of my car. The ten-minute drive was noticeably uncomfortable for her, and at every stop sign the pain appeared to escalate to another level. By the time we arrived at the hospital, my wife had been writhing in pain for so long that it took a bona fide effort to untangle the seat belt before I succeeded in unlatching it.
She was barely able to shuffle to the hospital entrance with my help, and with every step during the short journey to the waiting room, her pain intensified, as did her guttural moaning. Fortunately, the obstetrician was true to her word, and the admitting nurse was expecting us, a manila folder of paperwork in hand. I was able to fill out the insurance forms very quickly, and we were whisked into a private room to wait for the emergency-room physician. I then helped my wife into a flimsy gown and tried my best to comfort her when she curled into a fetal position on the examining table.
We were in the linoleum and stainless-steel room for what seemed like an eternity before a young male nurse showed up with a clipboard. By that time, Madisyn’s veins were visibly protruding from both sides of her flushed neck, and she began to shake uncontrollably while he proceeded to ask her the same questions I had already answered for the admitting nurse.
“So why are you here tonight?” he inquired in a calm voice while Madisyn’s legs were involuntarily kicking.
“Dr. Carducci told us to come to the emergency room immediately,” I replied. “She’s pregnant and she’s bleeding and she’s obviously in a lot of pain! Can you please give her something for the pain?!”
“I would like the patient to answer,” he said calmly as Madisyn ripped the white paper sheet off the padded table and let out a piercing scream. “Madisyn, when was the date of your last period?”
Surprisingly, Madisyn collected herself and retrieved the date from some part of her brain that wasn’t preoccupied by the pain. She then answered the rest o
f his questions as coherently as she could in between the sharp stabbing pains that increased in intensity and frequency.
After the nurse finished asking her the obligatory battery of mundane questions, he then removed a laminated yellow card from his clipboard and showed it to Madisyn. It had six circles with simply drawn facial expressions representing a continuum of suffering on a scale of 1 to 10. It seemed absurd to resort to such a childlike tool when any preschooler would have easily deduced that if the face on the far right indicated a 10 on the pain scale, my wife was obviously registering at least a 15.
“On a scale of 1 to 10, what is the pain that you are feeling right now?” the nurse asked matter-offactly.
“Ten,” she said weakly while clutching her abdomen. “Can I please get something for the pain?”
“Yes, I’m going to recommend to the doctor that we give you something to make you feel better. He’s with another patient right now, but he will be with you as soon as he’s done.”
Madisyn let out a frustrated sigh and closed her eyes tightly.
“Let me get you some ice chips,” he continued. “I’ll be right back.”
True to his word, the nurse returned with a small paper cup containing a few ice chips that Madisyn was able to extract moisture from.
Over the next hour, Madisyn’s situation progressed from bad to worse. During her episodes, it took nearly all of my strength to keep her on the examining table while she writhed in pain and her limbs thrashed independent of one another. The thin paper covering on the table had been ripped apart, much of it in large pieces of irregularly shaped confetti scattered on the floor. Fortunately, there were small breaks between her convulsions, although the reprieves became shorter as the night progressed.
I ultimately left the examining room during one of these breaks to seek out someone who might be available to help my wife. When I entered the hallway of the emergency wing, I was shocked to find that nobody was around. It was eerie how empty the hospital was, as several examining tables were wheeled up against the sterile walls, and rows of vacant desks had apparently been abandoned in the midst of work. The entire scene reminded me of being the last one out of an office building during a fire alarm. I briefly panicked that some tragedy might have struck while we were in the examining room, before I saw an orderly exiting the ladies’ room.
“Can I help you?” she asked in a vaguely condescending voice.
By this time I was getting nervous about leaving Madisyn by herself in the room, and I heard the anxiety manifest itself by way of my constricted throat. “My wife is getting worse!” I yelled. “Can someone please come in and give her something for the pain! She’s having convulsions now and is much worse than when we arrived!”
At that moment a bloodcurdling howl sounded from Madisyn’s room, and I ran down the hallway.
“I’ll find someone right now,” the orderly called after me in a concerned voice as I shoved open the door.
Inside, Madisyn was practically naked as a result of her contortions, and the flimsy hospital gown was drenched in blood. I ran to the examining table and did my best to comfort her as she dug her fingernails deep into my arm while letting out a piercing scream that echoed off the lime-green linoleum. Her breathing became more erratic, and she eventually began hyperventilating between screams.
“It’s okay,” I tried to reassure her. “The orderly said someone will be right here.”
Within just a few seconds, the first nurse we’d seen appeared at the door with a plastic bag of clear liquid suspended from an IV hanger. He quickly wheeled it next to Madisyn while I attempted to reclaim my wife’s modesty by draping her legs with the blood-soaked gown.
“I’m going to start your IV so we can give you something for the pain,” he said in a calm voice while attempting to hold her hand steady. “But you’re going to need to be still so I can insert the needle into your vein.”
Madisyn pulled herself away from the nurse and screamed loudly while writhing facedown on the examining table. By this time my own anxiety began to overtake me, and the lights appeared to dim as I desperately tried to turn my wife over onto her back. Watching her writhe in pain for hours on end was finally getting to me, and it took nearly all my resolve to remain “present.”
The nurse put his face just a few inches in front of Madisyn’s and squeezed her hand firmly while commanding her in an authoritative voice: “Breathe. Take a deep breath and breathe with me.” He then took a deep breath himself and repeated, “I need you to breathe so we can get your IV started. Breathe in deeply … one, two, three … good. Now breathe out slowly … one, two, three. Good. Isn’t that better?”
Remarkably, Madisyn followed his lead and began breathing with him until she started to calm down. I felt myself return to my body and began caressing my wife’s hair while the nurse deftly inserted the needle into her wrist. Within seconds he had secured it with three layers of tape and attached a narrow tube to the suspended plastic bag. I found myself temporarily distracted from the reality of the situation as I watched the hypnotizing drip making its way from the bag to my wife’s arm.
“Okay, try to be as still as possible so you don’t rip out your IV,” he said as he hurried toward the door. “I’ll be right back with the doctor to give you something for the pain.”
As soon as the door was shut, Madisyn contorted in agony, and her face turned a deep shade of purple, the veins in her neck protruding. She then began hyperventilating again and rolled onto her side, clutching her stomach. It took all my strength to keep her from rolling off the table, and whenever I tried to help her breathe, like the nurse had done, she dug her fingers hard into my arm and shrieked at the top of her lungs. By this time, my arm was so covered in blood that I wasn’t sure if it was from her or if she had succeeded in puncturing my skin with her nails.
When the nurse once again returned without a doctor, I was ready to yell at him before he said, “The doctor requested that I start you on morphine immediately.” He was carrying a tray of labeled vials that clinked against one another as he placed them on the metal table next to Madisyn’s IV. He pierced one of the small bottles with a hypodermic needle and sucked out the clear liquid before inserting it into a plastic cylinder protruding from the IV tube.
When the drug entered her veins, Madisyn had a surprised look on her face and froze for a few seconds, before letting out another scream that seemed slightly less intense than the ones that had preceded it. The nurse reassumed his position in front of my wife and once again calmed her down by helping her breathe.
“Does that feel better?” he asked in between breaths.
“Uh-huh,” she gasped. “A little.”
The nurse produced the yellow laminated pain card and repeated, “On a scale of 1 to 10 …”
Madisyn interrupted him with an agonizing howl that rattled the vials of medicine next to the examining table.
“Okay, let me give you another dose,” the nurse said while quickly preparing another syringe. “I started with a very small amount, so I’ll give you a little bit more.”
Although I was impatient about getting the pain under control, I was also thankful that he was being judicious with the drug. I had made a point of writing on the admission form that Madisyn was ultrasensitive to medication. Over the years I’d discovered that even a single tablet of over-thecounter pain reliever could leave her with side effects for days.
When the second dose entered her bloodstream, Madisyn let out an audible sigh, releasing the mountain of tension that had built up throughout the evening. The plum hue of her face lightened to a pale crimson almost immediately; and within just a few seconds more, faded to a flushed pink. For the first time in several hours I was able to recognize that the person writhing in a blood-soaked hospital gown was indeed my wife.
“Does that feel better?” the nurse asked softly.
“Uh-huh.” Her voice was hoarse from screaming and sounded like she had just returned from smoking in a coal mine for twenty-o
dd years.
“Let’s clean you up a bit.”
After removing the red-stained paper from the table and the floor, the nurse retrieved a kidneyshaped bedpan from under a cabinet and filled it with warm water. He sponged Madisyn’s legs to remove as much of the smeared blood as he could before she began tensing up again.
“It comes in waves,” she croaked, while digging her nails into my forearm. The hue of her skin once again deepened to crimson as she let out another ear-piercing scream. Madisyn arched her back involuntarily, and her eyes rolled to the back of her head. “Owwwwww,” she cried. “It huuurts …”
With a determined look, the nurse emptied a third vial of morphine into the tube, which rapidly produced the desired effect. “That should keep you for a little while. The intravenous meds work quickly, but they don’t last very long—we should probably get some meds into your muscle tissue so they will last longer.” He produced the laminated yellow pain chart and asked again, “On a scale of 1 to 10 …”
“Eight,” Madisyn whispered after a long pause.
Her eyes were no longer in the back of her head, and she began to breathe normally for the first time in hours.
“Are you okay?” I asked, gently caressing her tangled hair.
“No,” she responded plainly. “But at least now I don’t feel like I’m dying.”
I still felt helpless, although I was relieved that she was able to speak coherently.
“Roll over on your side,” suggested the orderly, who had prepared a fourth syringe. “I’m going to give you a shot of morphine into your muscle.” He inserted the needle into the flesh below my wife’s hip. Madisyn didn’t appear to notice the injection at all, although I felt myself wince for her. “This will last much longer than the IV medication.”
At that moment the doctor finally walked through the doorway. Harried green eyes complemented his frizzy white hair, which gave him the air of an annoyed professor.
“Sorry for the delay,” the doctor said in a perfunctory tone, after retrieving the clipboard from the nurse. “But it looks like we were able to take the edge off while we were waiting—it’s always busy during the full moon.” He quietly cleared his throat while flipping through the pages of the clipboard.